In this ambispective study, we evaluate the value of the recent consensus criteria and compare clinical characteristics and disability outcomes in patients with NMOSD as per their antibody status.

Neuromyelitis Optica (NMO) is a demyelinating disorder of central nervous system with predilection for optic nerve, spinal cord and brainstem. 

We included 97 patients following up at All India Institute of Medical Sciences, New Delhi, India. Patient data was collected retrospectively from records and prospectively from out-patient department from January 2012 until January 2018.

97 patients (28M/69F) with NMOSD were evaluated. 64 patients (65%) were positive for AQP4 antibody. Mean age of onset in was 28.11 years versus 29.67 years and 74.19% versus 65.7% were females in seropositive and seronegative groups respectively.

LETM (longitudinally extensive transverse myelitis) was the most common syndrome at disease onset in both groups (35% versus 42.8%).37% of patients classified as not definite (30 AQP4 positive and 7 AQP4 negative) as per Wingerchuk criteria could now be classified as NMOSD after application of consensus criteria, however 7 continue to remain non-classifiable (p<0.05).

There was no difference in age of onset, gender, clinical presentation as per the antibody status. There was no statistical difference in visual recovery as assessed by visual acuity and motor recovery as assessed by degree of ambulation in sero-positive and negative patients.

Application of Consensus criteria widens the inclusion of patients, gives them an opportunity to add immunomodulation & prevent further relapses. We found no difference in patients who are seropositive for AQP-4 IgG antibody as compared those who are sero-negative for the same.

Prognosis is similar in those with or without AQP-4 antibody irrespective of age of onset, disease course or visual/motor recovery.